OBJECTIVE To systematically review the status on pharmacist competency assessment tools both domestically and internationally， providing a theoretical basis for constructing scientific and applicable pharmacist competency assessment tools in China. METHODS Through literature review and comparative analysis， 15 representative domestic and international pharmacist competency assessment tools were systematically summarized， and their theoretical foundations， core dimensions， methodological characteristics and practical applications were compared and implications were given. RESULTS &CONCLUSIONS International research has established relatively mature evaluation systems. Represented by those developed from the United Kingdom， the United States， and the International Pharmaceutical Federation， these assessment tools demonstrate scientific structure， wide application， and dynamic and international applicability. While domestic research has progressed in sub-specialties such as clinical pharmacists， licensed pharmacists and pediatric pharmacists， it still faces challenges including insufficient standardization， inadequate validation， delayed updates， and limitations in practical application. The reasons for the disparities in assessment tools between China and other countries include differences in pharmaceutical care models， varying pharmacist training systems， cultural and social background factors， as well as differences in industry management and international influence. Based on this， the author suggests promoting the development and research of assessment tools for pharmacist job competency in China from four aspects： mechanism construction， system refinement， standardization development， and practical implementation.

The doublecortin (DCX) gene encodes DCX, a microtubule-associated protein that plays a crucial role in brain development. DCX variants can disrupt microtubule binding and stabilization, interfere with intracellular transport, and affect post-translational modifications. A correlation exists between variant types and clinical severity. Animal models and induced pluripotent stem cell (iPSC) models simulating DCX deficiency revealed the dynamic progression of the disease, which has provided a powerful tool for investigating disease mechanisms and screening therapeutic agents. Currently there is no cure for DCX variants, with treatment primarily relying on anti-epileptic drugs and symptom management. Basic research is now offering new avenues for future therapeutic approaches. This article has summarized the potential pathogenic mechanisms and therapeutic strategies for the DCX variants, with an aim to provide insights for clinical treatment.
Humans ; Doublecortin Protein ; Doublecortin Domain Proteins ; Animals ; Neuropeptides/metabolism* ; Microtubule-Associated Proteins/metabolism* ; Mutation

Objective To investigate the anatomical and microscopic structures of interstitial fluid flow channels in the skin tissue of hand dorsum in human cadavers.Methods Totally 7 fresh cadavers within 12 hours post-mortem were included.MRI was used to observe the distribution of interstitial fluid flow from the first phalanx of the fingers to the wrist,precisely locating the flow channels.Based on imaging results,histological analyses were conducted to determine the histological characteristics of the flow channels.Furthermore,multi-immunofluorescence and microcomputed tomography(Micro-CT)techniques were employed to analyze the channels,and image post-processing was used to elucidate their anatomical structures at the microscopic level.Results After injecting a contrast agent into the first phalanx of ten finger specimens and applying repeated pressure,MRI image revealed centripetal long-range interstitial fluid flow along channels distinct from blood vessels and lymphatic vessels.Histological analysis and Micro-CT further confirmed that the flow primarily occurred within the fibrous connective tissue and adventitia of the skin.Conclusion The orderly fibrous connective tissue and adventitia in the skin form the interstitial fluid flow channels in the human hand dorsum skin,named as"stromal membrane channels"in the skin.

Objective:To evaluate the performance of deep learning reconstruction (DLR) in visualizing lenticulostriate arteries (LSAs) on cerebral CT angiography (CTA).Methods:This cross-sectional study retrospectively analyzed cerebral CTA from 38 patients who underwent cerebral CTA at the Fourth Affiliated Hospital of Harbin Medical University between January and December 2023. Images were reconstructed using filtered back projection (FBP), three-dimensional adaptive iterative dose reduction (AIDR), and DLR-advanced inteuigent clear-IQ engine(AiCE) algorithms (FBP group, AIDR group, DLR-AiCE group). On axial images, the mean CT values, standard deviation (SD), signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were measured at the origin of LSAs, cerebrospinal fluid in lateral ventricles, temporal muscle, and head of the caudate nucleus. Subjective evaluations were performed for overall vascular visualization and LSAs delineation. Comparisons of subjective and objective evaluation indexes among the 3 groups were performed using the complex measurement ANOVA, Friedman test, or χ2 test. Results:The CT, SD, SNR and CNR values at the origin of LSAs, cerebrospinal fluid in lateral ventricles, temporal muscle, and head of the caudate nucleus demonstrated statistically significance among DLR-AiCE group, AIDR group and FBP group ( P<0.001), in which, except for the difference between the FBP group and the AIDR group in the CT value of the head of the caudate nucleus and the CT value of the cerebrospinal fluid of the lateral ventricle which was not statistically significant ( P>0.05), the remaining pairwise comparisons between the groups for each site measurements were statistically significant ( P<0.001). The difference in the overall comparison of the subjective scores of the overall vessels and LSAs in the images of the DLR-AiCE group, the AIDR group, and the FBP group was statistically significant ( P<0.001), and the two-by-two comparisons showed a statistically significant difference ( P<0.001) except for the difference in the subjective scores of LSAs between the FBP group and the AIDR group. Conclusion:The DLR-AiCE algorithm significantly reduces image noise and improves image quality, enabling superior visualization of LSAs, thereby enhancing diagnostic confidence.

Objective To investigate the impacts of neferine on cellular autophagy and apoptosis,and the silent mating type information regulation 2 homolog-1/5'-AMP activated protein kinase activated protein kinase/mammalian target of rapamycin(SIRT1/AMPK/mTOR)signaling path-way in acute myocardial infarction(AMI)rats.Methods A rat model of AMI was constructed on male SD rats,and then 72 successfully modeled rats were randomly divided into model group,low-and high-dose neferine groups,and high-dose neferine+SIRT1 inhibitor(EX-527)group,with 18 rats in each group.Another 18 normal rats served as the Control group.The area of myocardial infarction,expression of myocardocyte autophagy related proteins,myocardocyte apoptosis,and expression of SIRT1/AMPK/mTOR signaling pathway-related proteins were observed and detec-ted in above groups of rats.Results When compared with the model group,the low-and high-dose neferine groups exhibited milder pathological injuries,higher left ventricular ejection frac-tion,enhanced left ventricular fractional shortening,increased optical densities of microtubule associated protein 1 light chain 3(LC3)Ⅱ and Beclin-1,and elevated protein levels of LC3 Ⅱ/LC3 Ⅰ,Beclin-1,Bcl-2,SIRT1,and p-AMPK/AMPK(P＜0.05),and shorten left ventricular end-systolic diameter,lessened area of myocardial infarction,lower apoptotic rate,and reduced expres-sion of Bax and p-mTOR/mTOR(P＜0.05).While,in comparison to high-dose neferine treat-ment,addition of SIRT1 inhibitor,EX-527 resulted in more severe myocardial injuries,decreased left ventricular ejection fraction and left ventricular fractional shortening values,reduced optical densities of LC3 Ⅱ and Beclin-1,and down-regulated protein levels of LC3 Ⅱ/LC3 Ⅰ,Beclin-1,Bcl-2,SIRT1,and p-AMPK/AMPK(P＜0.05),but increased left ventricular end-systolic diame-ter,larger myocardial infarction area,increased apoptotic rate,and increased expression levels of Bax and p-mTOR/mTOR(P＜0.05).Conclusion Neferine can inhibit apoptosis and promote autophagy in AMI rats and exert myocardial protective effects,which may be related to the activa-tion of the SIRT1/AMPK/mTOR signaling pathway.

Objective:To retrieve, screen, evaluate and integrate the relevant evidence of nursing management for patent foramen ovale detected by contrast transesophageal echocardiography (cTEE) to provide a basis for clinical practice.Methods:A systematic search was conducted in relevant Chinese and English databases, guideline websites, and professional association websites such as China National Knowledge Infrastructure, Wanfang database, PubMed, and MedLink, etc. Relevant literatures on the detection of patent foramen ovale by cTEE were included, including guidelines, expert conconsensus, clinical decisions, evidence summaries, and systematic reviews. The search period was from the establishment of the database to July 31, 2024. Two evidence-based nursing researchers evaluated the quality of the literature and extracted relevant evidence in combination with clinical situations.Results:A total of 15 literatures were included. Among them, there were 3 guidelines, 6 expert consensuses, 3 clinical decisions, 2 quasi-experiments, and 1 systematic review. Thirty pieces of evidence were summarized from five aspects: assessment, education and publicity, preparation before examination, detection during examination, care after examination.Conclusions:The best evidence for the nursing management of patent foramen ovale detected by cTEE is of high quality and strong authority, which can provide evidence-based basis for standardizing clinical practice and accurately and efficiently detecting patent foramen ovale.

Objective:To investigate the effects of influenza A virus(IAV)on macrophages based on expression of cytokines mediated by Janus kinase/signal transducer and activator of transcription(JAK/STAT)pathway,and to further explore the intervention effects of Ma Xing Shigan decoction drug containing serum.Methods:RAW264.7 was divided into control group,JAK/STAT signal pathway activator group,inhibitor group,model group,oseltamivir group,antiviral granule group and Ma Xing Shigan decoction group.Cell samples were collected after the intervention of IAV and subsequent treating of drug-containing serum for 24 and 48 hours.Secretion levels of IL-1β and CXCL2 in supernatant were detected by ELISA.mRNA expression levels of influenza virus Nuclear Pro-tein(NP),JAK1/2 and STAT1 of cells were detected by RT-qPCR.Protein expression levels of JAK1/2 and STAT1 were detected by Western blot,and protein expression levels of p-STAT1 was detected by immunofluorescence.Correlation between protein expression levels of p-STAT1 and secretion of IL-1β and CXCL2 were evaluated by Pearson correlation analysis.Results:Secretion levels of IL-1β and CXCL2,mRNA expression levels of NP,JAK1/2,STAT1,protein levels of JAK1/2,STAT1 and p-STAT1 were increased,and protein levels of p-STAT1 was positively correlated with the secretion of IL-1β and CXCL2.Ma Xing Shigan decoction could down-regulate secretions of IL-1β and CXCL2,mRNA expression levels of NP,JAK1/2 and STAT1,protein expression levels of JAK1,JAK2,STAT1 and p-STAT1.Conclusion:Activation of JAK1/2-STAT1 signal pathway and imbalance of inflammatory factors may be one of the molecular mechanisms of immunopathological damage of macrophages induced by IAV.Ma Xing Shigan decoction may alle-viate pathogenic effects of IAV by regulating this signal pathway.

Objective:To investigate the effects of influenza A virus(IAV)on macrophages based on expression of cytokines mediated by Janus kinase/signal transducer and activator of transcription(JAK/STAT)pathway,and to further explore the intervention effects of Ma Xing Shigan decoction drug containing serum.Methods:RAW264.7 was divided into control group,JAK/STAT signal pathway activator group,inhibitor group,model group,oseltamivir group,antiviral granule group and Ma Xing Shigan decoction group.Cell samples were collected after the intervention of IAV and subsequent treating of drug-containing serum for 24 and 48 hours.Secretion levels of IL-1β and CXCL2 in supernatant were detected by ELISA.mRNA expression levels of influenza virus Nuclear Pro-tein(NP),JAK1/2 and STAT1 of cells were detected by RT-qPCR.Protein expression levels of JAK1/2 and STAT1 were detected by Western blot,and protein expression levels of p-STAT1 was detected by immunofluorescence.Correlation between protein expression levels of p-STAT1 and secretion of IL-1β and CXCL2 were evaluated by Pearson correlation analysis.Results:Secretion levels of IL-1β and CXCL2,mRNA expression levels of NP,JAK1/2,STAT1,protein levels of JAK1/2,STAT1 and p-STAT1 were increased,and protein levels of p-STAT1 was positively correlated with the secretion of IL-1β and CXCL2.Ma Xing Shigan decoction could down-regulate secretions of IL-1β and CXCL2,mRNA expression levels of NP,JAK1/2 and STAT1,protein expression levels of JAK1,JAK2,STAT1 and p-STAT1.Conclusion:Activation of JAK1/2-STAT1 signal pathway and imbalance of inflammatory factors may be one of the molecular mechanisms of immunopathological damage of macrophages induced by IAV.Ma Xing Shigan decoction may alle-viate pathogenic effects of IAV by regulating this signal pathway.

Objective:To analyze the mediating effects of psychological resilience on the relationship between perceived social support and health behavior capacity in patients with ischemic stroke.Methods:In this cross-sectional study, 500 patients with ischemic stroke were consecutively recruited using purposive sampling in the First People′s Hospital of Lianyungang between July and September in 2023. The sociodemographic characteristics, perceived social support scale, psychological resilience questionnaire and self-rated abilities for health practices scale in the patients were collected. A total of 500 questionnaires were distributed and 493 questionnaires were collected, of which 473 (95.9%) were valid. The structural equation model was constructed to explore the mediating effects of psychological resilience on the relationship between perceived social support and health behavior capacity in patients with ischemic stroke.Results:Among the 473 patients included in the analysis, there were 254 males and 219 females, with an average age of (66.8±11.4) years. The duration of stroke was less than 3 months for 329 patients (69.6%); the scores for perceived social support, psychological resilience and health behavior capacity was (59.68±11.15), (23.68±6.52), and (60.54±23.52), respectively. Perceived social support exerted significant direct effect ( β=0.334, bias-corrected 95% CI: 0.232-0.438) on health behavior capacity in patients with ischemic stroke, accounting for 63.62% of the total effect. Psychological resilience played a mediating role in the relationship between perceived social support and health behavior capacity ( β=0.191, bias-corrected 95% CI: 0.142-0.248), accounting for 36.38% of the total effect (all P<0.05). Conclusion:The health behavior capacity of patients with ischemic stroke is at a moderately low level, perceived social support may positively affect health behavior capacity through the positive mediating effect of psychological resilience.

Objective:To investigate the effect of cytoskeleton-associated protein 4 (CKAP4) gene knockout on maxillary expansion osteogenesis and its regulatory mechanism on the osteogenic differentiation of bone marrow mesenchymal stem cells (BMSC).Methods:Nineteen wild type (WT) and nineteen CKAP4 gene knockout (Ckap4 -/-) mice aged 6-8 weeks were selected to establish a mouse model of rapid maxillary expansion. Samples were taken on the 7th and 14th day after the operation. Micro-CT and HE staining were used to evaluate bone regeneration. Tissue proteins in the modeled area were collected, and Western blotting analysis (WB) was used to detect the protein expression levels of alkaline phosphatase (ALP), Runt-related transcription factor 2 (RUNX2), and osteocalcin (OCN). BMSC were isolated from WT and Ckap4 -/- mice. The expression of surface markers CD29, Sca-1, CD44, CD45, CD34, and CD11b was detected by flow cytometry, and cell proliferation ability was detected by 5-ethynyl-2'-deoxyuridine (EdU). After 7 days of osteogenic induction, real-time fluorescence quantitative PCR (RT-qPCR) and WB were used to detect the expression levels of RUXN2, ALP, OCN, protein kinase B (AKT), and phosphorylated protein kinase B (p-AKT). After 21 days, alizarin red staining and cetyl pyridine chloride quantification were used to detect the differences in mineralized nodule formation in each group. In CKAP4 gene knockout BMSC, the small-molecule AKT agonist sc79 (4 μg/ml) was added as the intervention group (Ckap4 -/- +sc79), and dimethyl sulfoxide (DMSO) treatment was used as the control group (Ckap4 -/- +DMSO). After osteogenic induction, RT-qPCR, WB, and alizarin red staining were used to compare the osteogenic differentiation differences between the two groups of cells. Results:The micro-CT results showed that at 7 days and 14 days after surgery, the new bone volume in the Ckap4 -/- group [(0.070±0.010) and (0.146±0.019) mm 3] was significantly lower than that in the WT group [(0.094±0.006) and (0.196±0.013) mm 3] (both P<0.01). HE-stained histological sections showed that the area of new bone tissue in the Ckap4 -/- group at 7 days and 14 days after surgery [(0.101±0.008) and (0.158±0.010) mm 2] was also significantly lower than that in the WT group [(0.116±0.005) and (0.183±0.008) mm 2] (both P<0.05). WB was used to detect the tissue proteins in the maxillary modeling area of mice in the two groups 7 days after surgery. The results showed that the expression levels of ALP, RUNX2 and OCN in the Ckap4 -/- group were significantly lower than those in the WT group. BMSC from wild-type mice and CKAP4 knockout mice were both positively expressed for CD29, CD44, and Sca-1, and basically not expressed for CD45, CD34, and CD11b. EdU assay showed that there was no significant difference in the proliferation ability of cells in the two groups. After 21 days of osteogenic induction of BMSC, alizarin red staining results showed that the number of mineralized nodules in the Ckap4 -/- group was significantly less than that in the WT group. After adding sc79, the number of mineralized nodules increased significantly, which was consistent with the results of cetyl pyridine chloride quantification. After 7 days of osteogenic induction, It was found that the expression levels of ALP, RUNX2, and OCN in the CKAP4 -/-group (0.751±0.066, 0.484±0.040, 0.679±0.063) were significantly lower than those in the WT group (1.000±0.113, 1.000±0.081, 1.000±0.113) (all P<0.001). The results of WB were consistent with those of RT-qPCR. At the same time, the WB results showed that the level of p-AKT protein in the CKAP4 -/-group (0.518±0.114) was significantly lower than that in the WT group (1.000±0.234) ( P<0.05). After treatment with sc79 for 7 days of osteogenic induction, RT-qPCR was used to detect the gene expression levels of ALP, RUNX2, and OCN. The results showed that the expression levels in the CKAP4 -/-+sc79 group (2.755±0.353, 4.800±0.990, 2.524±0.137) were significantly higher than those in the CKAP4 -/-+DMSO group (1.000±0.078, 1.000±0.247, 1.000±0.175) (all P<0.001). Conclusions:CKAP4 knockout inhibits the osteogenic differentiation of BMSC by reducing the activity of the PI3K/AKT signaling pathway, thereby suppressing osteogenesis in maxillary expansion.